Breast Cancer Survivors Face Severe Menopause Symptoms Without Hormonal Relief Options
Shlomit Laufer was diagnosed with breast cancer at 30 and underwent intensive treatments including chemotherapy, surgery, biological therapy, and radiation. Although the cancer went into remission, she had to start a prolonged anti-hormonal therapy to block estrogen, which can fuel certain breast cancers. This treatment forced her into premature menopause at 31, causing severe symptoms such as intense hot flashes, fatigue, mood swings, migraines, sleep disturbances, and loss of libido. Laufer has been on this therapy for nearly eight years and describes the daily struggle with these symptoms, which significantly impact her quality of life.
Laufer’s experience highlights a largely overlooked group of women, breast cancer survivors who cannot use hormone replacement therapy (HRT) due to the risk of cancer recurrence. While public discourse increasingly addresses menopause and HRT benefits, these women remain excluded from such solutions. A recent New York Times article underscored their isolation and the lack of awareness about non-hormonal treatments that might alleviate their symptoms.
Dr. Ora Rosengarten, a senior oncologist at Shaare Zedek Medical Center, explains that estrogen plays vital roles beyond reproductive health, including cardiovascular and neurological functions. Natural menopause involves a gradual estrogen decline, but anti-hormonal therapy in breast cancer survivors causes a drastic estrogen drop to near zero, intensifying symptoms. About two-thirds of breast cancer patients have hormone-sensitive tumors requiring this long-term therapy, often lasting five to ten years.
The severe symptoms, hot flashes, insomnia, anxiety, depression, and irritability, interact and worsen each other, severely affecting survivors’ daily functioning. Many women discontinue treatment due to side effects, increasing the risk of cancer recurrence. In Israel, about 80% complete therapy, but many suffer silently.
Non-hormonal interventions include physical activity, acupuncture, and certain medications originally developed for other conditions. Recently, new drugs targeting brain mechanisms responsible for hot flashes have emerged. One such drug, elinzanetant, showed significant symptom relief in breast cancer survivors on anti-estrogen therapy and is expected to be added to Israel’s health basket soon. However, Dr. Rosengarten stresses that medication complements but does not replace a healthy lifestyle, which remains crucial for improving quality of life and reducing cancer recurrence risk.
